Current Treatment Options in Neurology

, Volume 15, Issue 3, pp 241–258 | Cite as

Management of Secondary Progressive Multiple Sclerosis: Prophylactic Treatment—Past, Present, and Future Aspects


Opinion statement

Whereas the number of treatment options in relapsing-remitting multiple sclerosis (RRMS) is growing constantly, alternatives are rare in the case of secondary-progressive multiple sclerosis (SPMS). Besides mitoxantrone in North America and Europe, interferon beta-1b and beta-1a are approved for treatment in Europe. Glucocorticosteroids, azathioprine, intravenous immunoglobulins (IVIG) and cyclophosphamide (CYC), although not approved, are commonly utilized in SPMS. Currently monoclonal antibodies (mab), and masitinib are under examination for treatment for SPMS. Hematopoietic stem cell transplantation and immunoablative stem cell transplantation are therapies with the aim of reconstitution of the immune system. This review gives information on the different therapeutics and the trials that tested them. Pathophysiological considerations are presented in view of efficacy of the therapeutics. In addition, therapeutics that showed no efficacy in trials or with unacceptable side effects are topics of this review.


Secondary progressive multiple sclerosis Interferon beta-1b Interferon beta-1a Mitoxantrone Glucocorticosteroids Azathioprine Intravenous immunoglobulins Cyclophosphamide Masitinib Daclizumab Rituximab Linomide Treatment Prophylactic treatment Management 


Conflict of Interest

Paulus S. Rommer has served as a consultant for Bayer.

Olaf Stüve has received grant support from Teva Pharmaceuticals; served as a consultant for Biogen Idec, Genzyme, Novartis, and Sanofi Aventis; had travel/accommodations expenses covered/reimbursed by Teva Pharmaceuticals; served on boards for Archives of Neurology and Therapeutic Advances in Neurological Disorders; and received fees for participation in review activities such as data monitoring boards, statistical analysis, and end point committees from Teva Pharmaceuticals.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of NeurologyMedical University of ViennaViennaAustria
  2. 2.Department of Neurology and NeurotherapeuticsUniversity of Texas Southwestern Medical Center at DallasDallasUSA
  3. 3.Neurology Section, VA North Texas Health Care SystemDallas VA Medical CenterDallasUSA

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